Malignancy can be cured early with surgery or radiation therapy. However, if it is advanced and surgery is not possible, the goal is to ensure quality of life and prolong life. Throughout the treatment, our greatest concern is brain metastases, especially meningeal metastases, which will greatly threaten the survival of patients. Therefore, we urgently need new therapeutic measures and concepts.
The survival of cancer patients with brain metastases is worrying
For patients with advanced cancer with brain metastases, intravenous or oral medications often fail to enter the brain efficiently due to the presence of the blood-brain barrier. Although some drugs have a strong ability to enter the brain, the concentration of drugs entering the brain is often not enough.
In the case of melanoma, for example, if the cancer cells metastasize to the brain, the median survival time for patients tends to be only four to six months. Although many drugs have been approved in the treatment of melanoma, and many drugs, including PD-1 inhibitors, are used to treat melanoma, the survival of patients with brain metastases is still worrying.
Recently, researchers from the Brigham Healthcare System at Massachusetts General Hospital in the United States published a study in the journal Science Translational Medicine, and they developed a new immunotherapy method that has attracted a lot of attention.
Engineered "twin stem cell models" that attack meningeal cancer cells
Professor Khalid Shah of Harvard Medical School and Harvard Stem Cell Institute's Brigham School in the United States introduced that the new immunotherapy method they developed is sustainable and changes the future of brain metastasis treatment through local delivery.
The researchers designed an engineered "twin stem cell model" in which stem cells release a cancer cell killing virus (oncolytic virus), a way that kills cancer cells through oncolytic viruses has been shown to be effective. By using stem cells to deliver the virus, you can increase the amount of virus released and ensure that the virus is not degraded by circulating antibodies before being released into cancer cells.
However, there is a problem with existing immunotherapy methods: the oncolytic virus destroys the cells that release the virus at the same time, which makes the treatment effect unsustainable. To solve this problem, scientists used gene-editing technology to create a second stem cell, which does not become a target of oncolytic viruses, but instead releases a protein that strengthens the immune system, also known as an immunomodulator, to help fight cancer.
The twin stem cells are infused by intrathecal injection, which is commonly used to treat meningeal metastases. Unlike other immunotherapies, this twin stem cell infusion does not require repeated administration, only one infusion. The researchers also say the treatment could also be applied to other cancers with brain metastases, such as lung and breast cancer.
In the published findings, the researchers tested the innovative immunotherapy in preclinical animal models and confirmed its efficacy in mouse models of meningeal metastasis, with the hope of initiating clinical trials soon. The researchers are confident that their animal model trials have successfully replicated the environment of human clinical trials.
Discussion and analysis
Cancer is a reminder of innovative clinical trials. For patients with advanced cancer, when existing clinical treatment options are limited, active participation in new drug clinical trials is the best choice. When new drugs are still in clinical trials, they can be used for free if they can be enrolled, and once new drugs are approved for marketing, they are often expensive and not necessarily affordable for ordinary people. By participating in clinical trials, patients have the opportunity to use the latest treatments to achieve better outcomes for themselves.
In addition, some new treatments and concepts are often first developed overseas. Therefore, for cancers that lack treatment in Japan, such as pancreatic cancer and sarcoma, we can learn about new treatments overseas through overseas consultations and have the opportunity to participate in overseas clinical trials. Cancer degree will provide you with the opportunity to pay close attention to overseas clinical trials and seek the latest treatment options for patients.
Please pay attention to the degree of cancer, we will do our best to escort you on the road to cancer prevention and anti-cancer!
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Bibliography:
Nobuhiko Kanaya et al, Gene edited and engineered stem cell platform drives immunotherapy for brain metastatic melanomas, Science Translational Medicine (2023).